Infecciones tisulares por Streptococcus -hemolítico grupo A en Hospital Regional de Talca Tissue infections caused by group A hemolytic Streptococcus in a Regional Chilean Hospital

Background: A resurgence of group A hemolytic Streptococcus infections such as fasciitis, cellulitis and Strptococcal Toxic Syndrome has been observed recently. Aim: To study the clinical features of patients with group A hemolytic Streptococcus infections in a regional hospital. Patients and methods: Retrospective review of medical records of patients notified as having a group A hemolytic Streptococcus tissue infection, between 1994 and 1999. Results: twenty four patients were notified in the period as having a group A hemolytic Streptococcus infection and 18 (13 male, mean age 39 tears old) had tissue involvement. Eleven patients had a fasciitis (61%), six had a cellulitis (33%) and 14 patients (77%), a Streptococcal Toxic Shock Syndrome. Eight patients died during hospital stay. The infection portal of entry was identify in 13 patients (the skin in 10 and intramuscular injections in three). Deceased patients had a longer lapse of disease before admission than patients discharged alive (5(range 3h-7 days) and 2.1 (range 6h-5 days) respectively). In seven patients a quick serological test, designed for pharyngeal infections was performed and it was positive in five. Blood cultures were positive in seven patients and in 11, the germ was isolated from the lesions. Conclusions: As the early diagnosis of group A hemolytic Streptococcus tissue infections has a prognostic value, the population should be instructed to recognize early signs and symptoms of these infections (Rev Méd Chile 2000; 128: 1215-19)